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Lord Hunt’s selective quotations from the 1946 Act which founded the NHS,
and from the Efford Bill currently before Parliament, do not hit their target.
The actual text of Clause 1 of the Efford Bill that Lord Hunt quotes simply
copies and pastes from the 2012 Act. It’s not restoring any duty.

The Bill puts the Secretary of State back in charge but does not
re-establish a duty to provide the listed health services. I see that the House
of Commons library has just amended its briefing in this regard.

Why does Lord Hunt not mention the all-important Clause 3 of the Bill and
section 3 of the NHS Act 2006? Presumably, because he would then have to admit
that the Bill’s Clause 3 would transform the 2006 duty to provide listed health services throughout England into a
new duty to commission them, and with
no geographical stipulation.

There is also a slight concern is around the Bill’s approach to the notorious
Section 75 regulations which do much to force
competition onto local health bodies. The Bill repeals sections 72-80 of
the 2012 Health and Social Care Act - some of the key legislation around the
regulation of competition to provide NHS services. This is to be welcomed as a
step in the right direction of reducing tendering procedures. But for the
record, the Bill doesn’t actually “repeal… the Section 75 Regulations” – i.e.,
The National Health Service (Procurement, Patient Choice and Competition) (No. 2)
Regulations 2013. It repeals rather the power to make more such regulations in
the future. Presumably it is intended that they should be revoked, but this
must be clarified.

The TTIP clause is also only a partial exclusion. So
it also needs to be clarified why all NHS-relevant obligations under TTIP are
not excluded – whether they affect the UK government, NHS bodies (which are
undefined here) and non-NHS bodies, commissioners and providers alike. And why
does it not extend to other obligations, such as (for example) the ousting of
the jurisdiction of the UK courts, or to the rights of private companies to bid
for contracts?

There are two other, potentially more effective choices for Parliament here.
It can either legislate to restrict the Crown prerogative by stipulating that
the NHS cannot be included in TTIP. Or it can require the approval of
Parliament (and the devolved legislatures) before ratification – as proposed by
Clause 22 of the NHS Reinstatement Bill.

Professor Pollockadds:
Lord Hunt makes several implied references to the NHS Reinstatement Bill
without actually mentioning it. Our NHS Reinstatement Bill would abolish the
purchaser-provider split. Lord Hunt argues against it because he says it would
mean “another total top-down reorganisation of the NHS” and “staff that we meet
the length and breadth of the country plead with us to avoid another
reorganisation. The NHS would simply collapse under the strain having
been so weakened and demoralised by this Government”.

The NHS Reinstatement Bill would not be a total top-down reorganisation.
If it makes it to the Queen’s Speech in May 2015, that’ll be because voters -
including staff and patients - will have put pressure on Labour and other parties
to do so. That’s not top-down. That’s democracy. There are plenty of NHS staff
supporting the Reinstatement Bill and who oppose the continuing inefficient and
expensive market structures and mechanisms that are undermining the NHS and
equal access to healthcare.

We need to return the health system to a state where it is coherent, organised,
effective and efficient. This will inevitably require some structural changes,
but it will establish a system that is more functional and will remove those
elements of the current structure that are unnecessary and
wasteful.

Efford rightly describes the 2012 Act as “hated”. It is dissolving the
NHS as staff leave in droves. The NHS needs
restoring and strengthening. Demoralised staff need to be trusted and paid
properly. And we all need to know the NHS will be there for us when we need it.
The Reinstatement
Bill seeks to do just that.

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